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NURS 1510.  According to the Institute of Medicine, 44,000 – 98,000 people die each year because of “preventable” medical errors  Most often these deaths.

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Presentation on theme: "NURS 1510.  According to the Institute of Medicine, 44,000 – 98,000 people die each year because of “preventable” medical errors  Most often these deaths."— Presentation transcript:

1 NURS 1510

2  According to the Institute of Medicine, 44,000 – 98,000 people die each year because of “preventable” medical errors  Most often these deaths result from a combination of errors and oversights by several people, and not simply o person’s error=Procedural errors  The most common error involve medications

3  1. Patient identification: Improve the accuracy of patient identification: ◦ 2 identifiers: name band + DOB  2. Communication: improve the effectiveness of communication among caregivers: VO or PO note “read Back” Standardize abbreviations to be used

4  Improve the safety of using high-alert medications: Remove concentrated meds from client care units Standardize and limit the number of drug concentrations available per organization

5  4. Eliminate Wrong: eliminate wrong-site, wrong-patient, wrong procedure or surgery Create and use pre-op verification process, checklists, to confirm that appropriate documents are available Implement a process to mark the surgical site and involve client in the marking process

6  Improve the safety of using infusion pumps: ◦ Ensure free-flow protection on all general-use and PCA IV pumps by the organization  Improve the effectiveness of clinical alarm systems: ◦ Implement reg preventive maintenance and testing of alarm systems ◦ Assure alarms to be activated and audible

7  Infection control: ◦ Handwashing and reporting nosocomial infections ◦ Reporting deaths from nosocomial infections

8  Primary responsibility as a nurse is to protect client from harm  Safe environment includes: ◦ Comfortable ◦ Private ◦ Low risk of infection ◦ Low risk of injury ◦ Low risk of undesirable effects of RX, TX

9  Falls account for 90% of all reported incidents in hospitals  Hip Fx results in more hospital admissions than any other injury  Client- inherent accidents: accidents other than falls. Cuts, burns, seizure with injury  Procedure-Related accident: caused by HCO, med errors, contamination of equipment or wound

10  Improper performance of nursing procedure  Equipment-related incidents: result from the malfunction or improper use of medical equip-electrocution and fire. ◦ Mark faulty equipment ◦ Place in designated place ◦ Call bio-med

11  Oxygen-furnace malfunction leading to carbon monoxide. Gas binds with hemoglobin reducing available O2 to tissues  Nutrition-poor food handling and storage may lead to food poisoning, Hep A.  Temperature-exposure to extremes temperature=accidental hypothermia or heat exhaustion

12  MVA leading cause of death f/u by falls, poisonings, drowning, fires and burns.  Common Hazards in the home include: ◦ Inadequate lighting ◦ Clutter  Others: ◦ Lack of security ◦ Pathogens, carcinogens, sanitation and pollution

13  Developmental age: infant, toddler, preschooler need supervision hi risk for accidents ◦ School age sports injuries ◦ Adolescents have risk taking behaviors ◦ Adults life style concerns: alcohol, stress ◦ Older adults physiological changes of age, medications, other illnesses. The older, the greater the incidents of falls

14  Impaired mobility  Sensory impairments  Cognitive impairments  Safety awareness-placing meds out of reach of young children, maintaining smoke, CO2 detectors, furnace checks, wearing seat belts, etc

15  Consider your action and how they affect patient safety  Don’t leave products behind  Evaluate products before purchasing (avoid look a likes)  Know how to use products, equipment, etc  Don’t misuse containers  Stay alert for things that do not seem right  Take appropriate steps to address the problem  Trust your instincts and don’t make assumptions  Listen to patients as they express a problem and communicate it effectively

16  Healthcare is a complex system  Everyone makes errors or has near misses  Promote learning  Identify why key systems, processes, or procedures are in place, learn them and follow through correctly consistently

17  Falls  Physical / chemical restraint (see handout)  Bed/chair alarms  Side rails  Fire RACE: Rescue, Alarm, Confine, Extinguish or Evacuate  Code-BLS (see Alegent handout)

18  Body Image  Economics  Level of Knowledge  Socio-economic variables  Personal preferences  Physical condition  Age  Gender

19  Practice Standard precautions  Utilize safety practices  Provide privacy  Maintain body warmth –use bath blanket  Promote independence

20  Oral hygiene: cleanse teeth of food particles, plaque & bacteria  Massage gums to prevent periodontal ds  Moisturize oral mucosa  Improve sense of taste  Enhances client’s sense of well being  Palm dentures to clean

21  Note drainage  Soak gently with H20 if crusted  Wipe from inner to outer canthus EARS Note drainage Ear wax (cerumen) DO NOT use cotton tipped applicators

22  Maintain integrity  Control body odors  Improves self image  Promotes relaxation  Daily cleanse folds and peri area

23  Observe for dryness, inflammation  Corns, calluses  Clean toenails carefully  Dry thoroughly  DO NOT cut corns or calluses  Use lotion

24  File nails  Greenish-black indicates fungus growth  Note ingrown nails or thickened nails  DO NOT cut nails of diabetics  If ordered to cut nails in general population soak for 20 min to soften prior to cutting

25  Clean to soiled (outer to inner)  Front to back  Retract foreskin in uncircumcised male  Replace foreskin over glans after rinsing and drying  Rinse and dry area well

26  Promotes relaxation  Stimulates circulation  Opportunity to inspect skin  Relieves muscle tension  Promotes comfort

27  Complete bedbath Partial  Self with help –sponge bath  Shower Chair-shower  Tub-often avoided post-op  Tipid Sitz  Aveeno / oatmeal therapeutic


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